Main findings are summarized in this section, with full results provided as supplemental documentation.
Fragranced product use
Of the general population surveyed in America, 98.3 % are exposed to fragranced products at least once a week, from their own use: 72.8 % air fresheners and deodorizers; 88.8 % personal care products; 79.9 % cleaning supplies; 84.1 % laundry products; 77.0 % household products; 70.2 % fragrance; 3.0 % other.
Further, 92.1 % are exposed to fragranced product at least once a week, from others’ use: 57.9 % air fresheners and deodorizers; 66.1 % personal care products; 54.8 % cleaning supplies; 47.4 % laundry products; 52.3 % household products; 68.7 % fragrance; 3.2 % other.
Collectively, 99.1 % of the population are exposed to fragranced products at least once a week from their own use, others’ use, or both.
Overall, 34.7 % of the population reported one or more types of adverse health effects from exposure to one or more types of fragranced products. The most common types of adverse effects were as follows: 18.6 % respiratory problems; 16.2 % mucosal symptoms; 15.7 % migraine headaches; 10.6 % skin problems; 8.0 % asthma attacks; 7.2 % neurological problems; 5.8 % cognitive problems; 5.5 % gastrointestinal problems; 4.4 % cardiovascular problems; 4.0 % immune system problems; 3.8 % musculoskeletal problems; and 1.7 % other.
Of the 34.7 % of the population reporting adverse health effects, 56.1 % are female and 43.9 % are male. Thus, proportionately more females report adverse effects than males, relative to the general population (female 53.8 %, male 46.2 %).
Products and exposure situations that trigger adverse health effects include the following:
Air fresheners and deodorizers: 20.4 % reported health problems when exposed to air fresheners or deodorizers (9.5 %, respiratory problems, 7.6 % mucosal symptoms, 7.2 % migraine headaches, 5.7 % skin problems, 4.7 % asthma attacks, 3.2 % neurological problems, and others). This compares to previous studies (Caress and Steinemann 2009) that found 17.5 and 20.5 % of the population (in 2002–2003 and 2005–2006, respectively) reported headaches, breathing difficulties, or other health problems when exposed to air fresheners or deodorizers.
Scented laundry products vented outdoors: 12.5 % reported health problems from the scent of laundry products coming from a dryer vent (4.2 % mucosal symptoms, 4.0 % respiratory problems, 3.6 % skin problems, 3.3 % migraine headaches, 2.6 % gastrointestinal problems, 2.5 % asthma attacks, and others). This compares to previous studies (Caress and Steinemann 2009) that found 10.9 % of the population (in 2005–2006) reported headaches, breathing difficulties, or other health problems when exposed to the scent of laundry products vented outside.
Proximity to fragranced person: 23.6 % reported health problems from being near someone who is wearing a fragranced product (10.4 % respiratory problems, 8.6 % mucosal symptoms, 8.5 % migraine headaches, 3.9 % asthma attacks, 3.6 % neurological problems, 3.4 % skin problems, and others). This compares to previous studies (Caress and Steinemann 2009) that found 31.1 and 29.9 % of the population in (2002–2003 and 2005–2006, respectively) reported headaches, breathing difficulties, or other health problems when next to someone wearing a scented product.
Cleaning products: 19.7 % reported health problems from being in a room after it has been cleaned with scented products (9.6 %, respiratory problems, 7.3 % mucosal symptoms, 6.6 % migraine headaches, 4.1 % neurological problems, 4.0 % asthma attacks, 4.0 % skin problems, and others).
Severity of the health problems resulting from exposure to one or more types of fragranced products was investigated, using the language from the Americans with Disabilities Act (ADA 1990) to determine disability: “Do any of these health problems substantially limit one or more major life activities, such as seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, or working, for you personally?” Of the general population, 17.2 % reported yes, indicating that the severity of effects from fragranced product exposure was potentially disabling.
Ingredient disclosure and product claims
Fragranced products (even ones called green or organic) emit a range of volatile organic compounds, including hazardous air pollutants, but relatively few are disclosed to the public (Steinemann 2015).
Of the general population surveyed, 46.4 % were not aware that a “fragrance” in a product is typically a chemical mixture of several dozen to several hundred chemicals, and 64.6 % were not aware that fragrance chemicals do not need to be fully disclosed on the product label or material safety data sheet. Further, 67.3 % were not aware that fragranced products typically emit hazardous air pollutants such as formaldehyde, and 72.6 % were not aware that even so-called natural, green, and organic fragranced products typically emit hazardous air pollutants. However, 60.1 % would not still use a fragranced product if they knew it emitted hazardous air pollutants.
Societal and workplace effects
Use of fragranced products in society can lead to a range of perhaps unintended yet serious consequences. Of the general population, 17.5 % are unable or reluctant to use the toilets in a public place, because of the presence of an air freshener, deodorizer, or scented product. Also, 14.1 % are unable or reluctant to wash their hands with soap in a public place, because they know or suspect that the soap is fragranced. Further, 22.7 % have been prevented from going to some place because they would be exposed to a fragranced product that would make them sick.
Significantly, 15.1 % of the general population reported that exposure to fragranced products in their work environment has caused them to become sick, lose workdays, or lose a job. Also, 20.2 % of the population reported that if they enter a business, and smell air fresheners or some fragranced product, they want to leave as quickly as possible.
Fragrance-free policies receive a strong majority of support. Of the population surveyed, 53.2 % would be supportive of a fragrance-free policy in the workplace (compared to 19.7 % that would not). Thus, 2.7 times more people would vote yes for a fragrance-free workplace than not. Also, 54.8 % would prefer that health care facilities and health care professionals be fragrance-free (compared to 22.4 % that would not). Thus, nearly 2.5 times more people would vote yes for fragrance-free health care facilities and professionals than not.
Public venues and businesses such as airplanes and hotels have been pursuing a trend of scent branding, or dispersing fragranced air through their indoor environments. However, customers may not necessarily prefer scented air.
If given a choice between flying on an airplane that pumped scented air throughout the passenger cabin, or did not pump scented air throughout the passenger cabin, 59.2 % would choose an airplane without scented air (compared to 23.6 % with scented air). Thus, over 2.5 times more passengers would prefer an airplane without scented air than with scented air. Similarly, if given a choice between staying in a hotel with fragranced air, or without fragranced air, 55.5 % would choose a hotel without fragranced air (compared to 27.8 % with fragranced air). Thus, about two times more hotel guests would choose a hotel without fragranced air than with fragranced air.